| NPI | 1730154345 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME 115908) | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 115908) | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 5711802-1205) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ID M-9651) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: UT 5711802-1205) | |
| Enumeration Date | 2006-02-17 | 
| Last Update Date | 2021-04-16 |